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Upper Endoscopy With Heat Treatment For Reflux

Michigan rates for HCPCS 43257

A flexible scope is passed through the mouth down to the junction where the esophagus meets the stomach, and controlled heat energy is applied to the muscle of that valve area. The treatment aims to firm up the valve so stomach contents wash back up less easily. It is used for long-standing heartburn and reflux.

Rates data updated October 2026.

How much does Upper Endoscopy With Heat Treatment For Reflux cost?

$1,546

Typical total for the visit. In Michigan, October 2026.

Insurers have agreed to pay about $1,546 for this procedure. That total is two separate charges: $316 to the doctor who performs it, and $1,230 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$316$288 to $372
Facility feeThe hospital or surgery center$1,230$871 to $2,455

How much rates vary

Facilitymedian $1,230 · 10th to 90th $490 to $5,129Professionalmedian $316 · 10th to 90th $63 to $457
$100$200$500$1K$2K$5K$10Kfacility $1,230professional $316

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$295.12
Median
$4,073.80
Typical High
$5,754.40
Aetna
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$288.40
Typical High
$295.12
Aetna
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$28.84
Median
$28.84
Typical High
$29.51
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$316.23
Typical High
$316.23
Cigna
Setting
Facility
Modifier
None
Typical Low
$630.96
Median
$630.96
Typical High
$630.96
Cigna
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$302.00
Typical High
$501.19
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$831.76
Median
$1,479.11
Typical High
$4,897.79
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$295.12
Median
$331.13
Typical High
$446.68
Health Alliance Plan
Setting
Professional
Modifier
54 · Surgery only
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Health Alliance Plan
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$43.65
Median
$43.65
Typical High
$43.65
Health Alliance Plan
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$29.51
Median
$29.51
Typical High
$29.51
Priority Health
Setting
Facility
Modifier
None
Typical Low
$630.96
Median
$630.96
Typical High
$630.96
Priority Health
Setting
Professional
Modifier
None
Typical Low
$181.97
Median
$288.40
Typical High
$467.74
United
Setting
Facility
Modifier
None
Typical Low
$602.56
Median
$1,230.27
Typical High
$5,248.07
United
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$371.54
Typical High
$489.78

Where Michigan sits

The same service costs 8.4 times more in Wisconsin than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

Michigan· 48th of 51

$1,546

$316 physician + $1,230 facility

WI $6,091MT $726

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.